scholarly journals ENVIRONMENTALLY SUSTAINABLE DIET AND RECYCLING THERAPY FOR OLDER ADULTS’ WELL-BEING AND HEALTHCARE EXPENDITURES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S734-S734
Author(s):  
Hsinyi Hsiao ◽  
Aaron Hagedorn
Keyword(s):  
Climate Change ◽  
Older Adults ◽  
Health Care ◽  
Environmental Sustainability ◽  
Large Scale ◽  
Health Care Expenditures ◽  
Well Being ◽  
Medical Expenditure ◽  
Environmentally Sustainable ◽  
Longitudinal Effects

Abstract Due to the rapid climate change in recent years, global communities have seen an increased frequency of large-scale natural and man-made disasters. Acknowledging extravagant lifestyles and wasteful consumption of natural resources as prominent factors leading to intensified stress placed on the biosphere and ecosystems, many older adults with chronic medical conditions or disabilities in Taiwan have promoted environmental sustainability through two ways: 1) participating a recycling program in their local communities by collecting, sorting, and reclaiming reusable resources that are regenerated into eco-friendly blankets for disaster survivors and 2) practicing plant-based diet to promote healthy lifestyle and mitigate climate change. These older participants of environmentally sustainable initiatives believe the interconnectedness among humanity, the environment, and sustainable lifestyles. To understand association between the recycling therapy and older adults’ well-being a quasi-experimental design with 72 people age 60 and older (recycling group vs. non-recycling group) and photovoice were used to examine longitudinal effects of the recycling therapy on physical and mental health. To examine the effects of plant-based diet on dementia and health care cost ten-year data from Taiwan’s National Health Insurance Database were used by two studies to compare risk of dementia and medical expenditure between vegetarian and non-vegetarian groups among older adults in Taiwan. Four presentations in the symposium will discuss positive outcomes of environmental volunteering on older adults’ physical and mental wellness and longitudinal effects of a cohort with environmental-friendly diet on dementia risk and lower actual health care expenditures.

Nationally Representative Health Care Expenditures of Community-Based Older Adults with Pain in the United States Prescribed Opioids vs Those Not Prescribed Opioids

Pain Medicine ◽  
2020 ◽  
Author(s):  
David R Axon ◽  
Marion Slack ◽  
Leila Barraza ◽  
Jeannie K Lee ◽  
Terri Warholak
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Emergency Room ◽  
Health Care Expenditures ◽  
Medical Expenditure ◽  
Community Based ◽  
Opioid Prescription ◽  
The Past ◽  
Nationally Representative ◽  
Prescription Status

Abstract Objective To compare health care expenditures between older US adults (≥50 years) with pain who were prescribed opioid medications and those who were not. Design Cross-sectional. Setting Community-based adults in the 2015 Medical Expenditure Panel Survey (MEPS). Subjects Nationally representative sample of US adults alive for the calendar year, aged 50 years or older, who reported having pain in the past four weeks. Methods Older US adults (≥50 years) with pain in the 2015 MEPS data were identified. The key independent variable was opioid prescription status (prescribed opioid vs not prescribed opioid). Hierarchical linear regression models assessed health care expenditures (inpatient, outpatient, office-based, emergency room, prescription medications, other, and total) in US dollars for opioid prescription status from a community-dwelling US population perspective, adjusting for covariates. Results The 2015 study cohort provided a national estimate of 50,898,592 noninstitutionalized US adults aged ≥50 years with pain in the past four weeks (prescribed opioid N = 16,757,516 [32.9%], not prescribed opioid N = 34,141,076 [67.1%]). After adjusting for covariates, individuals prescribed an opioid had 61% greater outpatient (β = 0.477, P < 0.0001), 69% greater office-based (β = 0.524, P < 0.0001), 14% greater emergency room (β = 0.131, P = 0.0045), 63% greater prescription medication (β = 0.486, P < 0.0001), 29% greater other (β = 0.251, P = 0.0002), and 105% greater total (β = 0.718, P < 0.0001) health care expenditures. There was no difference in opioid prescription status for inpatient expenditures (P > 0.05). Conclusions This study raises awareness of the economic impact associated with opioid use among US older adults with pain. Future research should investigate these variables in greater depth, over longer time periods, and in additional populations.

Older adults’ philanthropic crafting of face masks during COVID-19

2021 ◽  
Vol 12 (2) ◽  
pp. 223-245 ◽  
Author(s):  
Christine Guy Schnittka
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Social Media ◽  
Virtual Community ◽  
Well Being ◽  
Moral Values ◽  
Lessons Learned ◽  
Front Line ◽  
Social Media Platforms ◽  
Front Line Workers

During the early months of the COVID-19 pandemic, people of all ages began sewing fabric face masks. Organized through separate grassroots movements, oftentimes using social media platforms, people pooled their resources to make masks for front line workers and others in desperate need. While some people sold these face masks, many participated in philanthropic crafting, donating them to hospitals and other health care centres. Older adults were identified early on as being particularly vulnerable to the effects of the virus, and so their response to mitigate the impacts of the pandemic through crafting was salient. This study investigated the experience of philanthropic hand crafting by older adults who were living through the COVID-19 pandemic. Twenty-seven older adults of age 60–87 who sewed masks for others were interviewed. A comprehensive data analysis of these interviews yielded 39 descriptive codes that were collapsed into eight themes: emotions, engagement, meaning, relationships, accomplishment, intellect, moral values and agency. One finding was that there were psychological, relational and existential benefits for the crafters. Making masks allowed participants to help other people, and it gave the participants a feeling of value, worthiness and purpose. Additionally, participants felt more in control in a chaotic world as they made masks to protect themselves, their loved ones, as well as strangers. The philanthropic crafting enhanced older adults’ well-being in many ways, and lessons learned from this study could be extended into ‘normal times’. For example, more older adults would be able to participate in craft-based philanthropy if they had access to the tools and materials. They would be more motivated if they received thank you notes and pictures of the recipients using their handmade gifts, and if they could express their creativity more. Finally, creating a physical or virtual community for older adults around craft philanthropy would help older adults feel more connected to and supported by their peers, and the community at large.

Incremental health care services and expenditures associated with depression among individuals with cutaneous lupus erythematosus (CLE)

Lupus ◽  
2018 ◽  
Vol 27 (7) ◽  
pp. 1107-1115 ◽  
Author(s):  
M E Ogunsanya ◽  
S O Nduaguba ◽  
C M Brown
Keyword(s):  
Health Care ◽  
Prescription Drugs ◽  
Lupus Erythematosus ◽  
Medical Expenditure Panel Survey ◽  
Cutaneous Lupus Erythematosus ◽  
Health Care Expenditures ◽  
Medical Expenditure ◽  
Care Utilization ◽  
Medication Costs ◽  
Cutaneous Lupus

Objectives The objective of this paper is to describe the annual direct medical expenditures for cutaneous lupus erythematosus (CLE) patients, and to estimate the incremental health care expenditures and utilization associated with depression among adults with CLE, while controlling for covariates. Methods Using the 2014 Medical Expenditure Panel Survey (MEPS), we compared CLE patients with and without depression to determine differences in: (a) health care utilization—inpatient, outpatient, office-based and emergency room (ER) visits, and prescriptions filled; and (b) expenditures—total costs, inpatient, outpatient, office-based, ER, and prescription medication costs, and other costs using demography-adjusted and comorbidity-adjusted multivariate models (age, gender, race/ethnicity, marital status, education, perception of health status, poverty category, smoking status, and Charlson Comorbidity Index). Results The total direct medical expenditure associated with CLE is estimated at approximately $29.7 billion in 2014 US dollars. After adjusting for covariates, adults with CLE and depression had more hospital discharges (utilization ratio (UR) = 1.13, 95% confidence interval (CI) (1.00–1.28)), ER visits (UR = 1.17, 95% CI (1.09–1.37)), and prescribed medicines (UR = 2.15, 95% CI (1.51–3.05)) than those without depression. Adults with CLE and depression had significantly higher average annual total expenditure that those without depression ($19,854 vs. $9735). Conclusions High health care expenditures are significant for patients with CLE, especially among those with depression. Prescription drugs, inpatient visits, and ER visits contributed most to the total expenditures in CLE patients with depression. Early diagnosis and treatment of depression in CLE patients may reduce total health care expenditures and utilization in this population.

Comparison of Health Care Expenditures Among U.S. Older Adults With Pain Who Reported Frequent Exercise Versus Nonfrequent Exercise

2021 ◽  
pp. 1-9
Author(s):  
David R. Axon ◽  
Jonathan Chien ◽  
Hanh Dinh
Keyword(s):  
Health Care ◽  
Medical Expenditure Panel Survey ◽  
Survey Design ◽  
Health Care Expenditure ◽  
Prescription Medication ◽  
Health Care Expenditures ◽  
Cross Sectional Study ◽  
Medical Expenditure ◽  
Cross Sectional ◽  
Nationally Representative

This cross-sectional study included a nationally representative sample of U.S. adults aged ≥50 years with self-reported pain in the past 4 weeks from the 2018 Medical Expenditure Panel Survey. Adjusted linear regression analyses accounted for the complex survey design and assessed differences in several types of annual health care expenditures between individuals who reported frequent exercise (≥30 min of moderate–vigorous intensity physical activity ≥5 times per week) and those who did not. Approximately 23,940,144 of 56,979,267 older U.S. adults with pain reported frequent exercise. In adjusted analyses, individuals who reported frequent exercise had 15% lower annual prescription medication expenditures compared with those who did not report frequent exercise (p = .007). There were no statistical differences between frequent exercise status for other health care expenditure types (p > .05). In conclusion, adjusted annual prescription medication expenditures were 15% lower among older U.S. adults with pain who reported frequent exercise versus those who did not.

scholarly journals The Role of Immigration in the Health of Lesbian, Gay, Bisexual, and Transgender Older Adults in the United States

2019 ◽  
Vol 89 (1) ◽  
pp. 3-21
Author(s):  
Jane J. Lee ◽  
Hyun-Jun Kim ◽  
Karen Fredriksen Goldsen
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Behaviors ◽  
Health Outcomes ◽  
Health Care Access ◽  
Well Being ◽  
The United States ◽  
Foreign Born ◽  
Care Access ◽  
Bisexual And Transgender

Lesbian, gay, bisexual, and transgender (LGBT) aging research is growing around the globe. Yet, few studies have examined the interconnectedness of different populations and cultures. This study examines whether LGBT foreign-born older adults experience greater health disparities than their U.S.-born counterparts. We conducted a cross-sectional analysis of the National Health, Aging, and Sexuality/Gender Study: Aging with Pride from 2014, which assessed measures of health and well-being among LGBT adults aged 50 years and older ( n = 2,441). We compared sociodemographic characteristics, health-care access, health behaviors, and health outcomes between foreign-born and U.S.-born participants. Foreign-born LGBT older adults reported greater socioeconomic disadvantage and higher levels of experiencing barriers to health-care access than U.S.-born LGBT older adults. Groups did not significantly differ in health behaviors and health outcomes when controlling for sociodemographic factors. Greater understanding of the mechanisms that shape the relationship between migration and health among the LGBT population is warranted.

scholarly journals Contextualizing the COVID-19 Era in Puerto Rico: Compounding Disasters and Parallel Pandemics

2020 ◽  
Author(s):  
Catherine García ◽  
Fernando I Rivera ◽  
Marc A Garcia ◽  
Giovani Burgos ◽  
María P Aranda
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Puerto Rico ◽  
Puerto Rican ◽  
Debt Crisis ◽  
Wealth Inequality ◽  
Well Being ◽  
Research Report ◽  
The Impact ◽  
Health And Well Being

Abstract Objectives The COVID-19 outbreak has worsened the ongoing economic crisis in Puerto Rico by creating “parallel pandemics” that exacerbate socioeconomic and health inequalities experienced by its most vulnerable residents. Unfortunately, conditions on the island have been largely overlooked by national media outlets and the mainland U.S. population. Thus, this research report aims to draw attention to the disparate burden multiple and compounding disasters have on older island-dwelling Puerto Rican adults’ health and well-being. Methods We characterize the lived experiences of the older population in Puerto Rico by incorporating data from multiple sources and contextualizing the effects of compounding disasters, the fiscal pandemic, and health care challenges to provide a more nuanced portrait of existing compounding factors that negatively affect the health and well-being of older adults in the era of COVID-19. Results We highlight 2 main factors that exacerbate pre-pandemic inequities experienced by the older adult population amid the COVID-19 pandemic in Puerto Rico: (a) the impact of multiple and compounding disasters; and (b) health care challenges. Discussion The human suffering of the Puerto Rican population is compounded by the consequences of fiscal austerity, increasing levels of income and wealth inequality, the debt crisis, significant emigration, and a dysfunctional health care system. Future governmental actions are required to lessen the burden of parallel pandemics on older adults in Puerto Rico.

scholarly journals Racial and ethnic patterns and differences in health care expenditures among Medicare beneficiaries with and without cognitive deficits or Alzheimer’s disease and related dementias

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sungchul Park ◽  
Jie Chen
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Health Care ◽  
Ethnic Groups ◽  
Ethnic Differences ◽  
Cognitive Deficits ◽  
Health Care Expenditures ◽  
Medical Expenditure ◽  
Medicare Beneficiaries ◽  
Racial And Ethnic Differences

Abstract Background Numerous studies have documented racial and ethnic differences in the prevalence and incidence of Alzheimer’s disease and related dementias (ADRD). Less is known, however, about racial and ethnic differences in health care expenditures among older adults at risk for ADRD (cognitive deficits without ADRD) or with ADRD. In particular, there is limited evidence that racial and ethnic differences in health care expenditures change over the trajectory of ADRD or differ by types of service. Methods We examined racial and ethnic patterns and differences in health care expenditures (total health care expenditures, out-of-pocket expenditures, and six service-specific expenditures) among Medicare beneficiaries without cognitive deficits, those with cognitive deficits without ADRD, and those with ADRD. Using the 1996–2017 Medical Expenditure Panel Survey, we performed multivariable regression models to estimate expenditure differences among racial and ethnic groups without cognitive deficits, those with cognitive deficits without ADRD, and those with ADRD. Models accounted for survey weights and adjusted for various demographic, socioeconomic, and health characteristics. Results Black, Asians, and Latinos without cognitive deficits had lower total health care expenditures than whites without cognitive deficits ($10,236, $9497, $9597, and $11,541, respectively). There were no racial and ethnic differences in total health care expenditures among those with cognitive deficits without ADRD and those with ADRD. Across all three groups, however, Blacks, Asians, and Latinos consistently had lower out-of-pocket expenditures than whites (except for Asians with cognitive deficits without ADRD). Furthermore, service-specific health care expenditures varied by racial and ethnic groups. Conclusions Our study did not find significant racial and ethnic differences in total health care expenditures among Medicare beneficiaries with cognitive deficits and/or ADRD. However, we documented significant differences in out-of-pocket expenditures and service-specific expenditures. We speculated that the differences may be attributable to racial and ethnic differences in access to care and/or preferences based on family structure and cultural/economic factors. Particularly, heterogeneous patterns of service-specific expenditures by racial and ethnic groups underscore the importance of future research in identifying determinants leading to variations in service-specific expenditures among racial and ethnic groups.

scholarly journals Age Moderates Perceived COVID-19 Disruption on Well-Being

2020 ◽  
Author(s):  
Amy Knepple Carney ◽  
Allyson S Graf ◽  
Grace Hudson ◽  
Ellen Wilson
Keyword(s):  
Older Adults ◽  
Negative Affect ◽  
Perceived Stress ◽  
Large Scale ◽  
Negative Impact ◽  
Well Being ◽  
Community Dwelling ◽  
Middle Aged ◽  
Age Related ◽  
Design And Methods

Abstract Background and Objectives It is not fully understood how large-scale events affect well-being. Older adults showed the highest levels of resilience following the September 11th (9/11) terrorist attacks, but during the severe acute respiratory syndrome outbreak, there were no age-related differences in well-being. The current study examined the Coronavirus Disease 2019 (COVID-19) disruption on well-being throughout adulthood. Research Design and Methods Perceived stress and affect were examined in 166 community-dwelling adults (Mage = 35.65; SD = 15.53; range = 18–79) in relation to the perceived disruption of the COVID-19 pandemic to their lives. Results A significant moderation was found for age and COVID-19 disruption on perceived stress [F(5, 153) = 8.88, p < .05, R2 = .22] and negative affect [F(5, 154) = 4.91, p < .05, R2 = .14], but not for positive affect. For participants over 50, those who rated COVID-19 as a low or high disruption had similar scores on stress and negative affect, but with younger aged participants, perceiving high disruption corresponded with higher levels of stress and negative affect. Discussion and Implications Findings are consistent with the strength and vulnerability integration (SAVI) model, wherein older adults try to maintain positive emotional well-being, with middle-aged and older adults in the current study having experienced less negative impact on well-being. Middle-aged and older adults may be better able to regulate negative emotions from COVID-19 than younger adults. SAVI proposes a greater negative impact on older adults when they experience sustained stressors; as the challenges with COVID-19 continue, further data will need to be examined.

Health Services Use and Costs for Americans With Intellectual and Developmental Disabilities: A National Analysis

2018 ◽  
Vol 56 (2) ◽  
pp. 101-118 ◽  
Author(s):  
Glenn T. Fujiura ◽  
Henan Li ◽  
Sandy Magaña
Keyword(s):  
Health Care ◽  
Health Status ◽  
Developmental Disabilities ◽  
Health Services ◽  
Health Care Expenditures ◽  
Medical Expenditure ◽  
Intellectual And Developmental Disabilities ◽  
Medication Costs ◽  
Study Results ◽  
National Analysis

Abstract Health services and associated costs for adults with intellectual and developmental disabilities (IDD) were nationally profiled and the predictors of high expense users statistically modeled. Using linked data from the National Health Interview Survey and Medical Expenditure Panel Survey for the years 2002 through 2011, the study found a mixed pattern of differences in rates of service use and costs when compared to the general population depending upon personal characteristics, health status, and type of health care service. Prescription medication costs were the primary driver of total health care expenditures for Americans with IDD. The presence of secondary chronic health conditions and poor mental health status were the consistent predictors of high expense users across types of health care. Study results are discussed in terms of implications for more nuanced evaluations of health care costs and need for recurring surveillance of health care for Americans with IDD in the years following passage of the Patient Protection and Affordable Care Act.

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